Key references and links
The following links present relevant general and specific UK references which outline good practice and guidance about safeguarding children as well as the relevant UK children’s legal framework.
- Royal College of Paediatrics and Child Health (RCPCH) – a large suite of resources which provide references, advice and training resources most of which are free to access online.
- General Medical Council (GMC) - protecting children and young people: doctors' responsibilities.
- National Institute for Health and Care Excellence (NICE) – Child maltreatment: when to suspect maltreatment in under 18s.
- Social Care Institute for Excellence (SCIE) - useful links and advice particularly about children, young people and adults with additional needs.
- National Society for the Prevention of Cruelty to Children (NSPCC) – Safeguarding children: what organisations need to do to protect children from harm (includes specific guidance for the four nations). Also available are links and resources to recent reports and statistics. The NSPCC website also has some superb resources including up-to-date cross UK guidance which is specific to each country.
- United Nations International Children's Emergency Fund (UNICEF) – United Nations Convention on the Rights of the Child
- HM Government - Working Together to Safeguard Children (2023) – In England, the revised edition of Working Together came into effect in August 2023. A useful summary of the changes is available from the NSPCC - here.
- NHS England has a number of policies in place in order to discharge its statutory requirements and appropriate accountability for the safeguarding of children , young people and adults at risk of harm or abuse. The policies for safeguarding set out in the legislation and codes of conduct and behaviours required of employees of NHS. It also publishes an annual report.
- UK law (England, Wales, Northern Ireland): Children Act 1989, Children Act 2004
- NHS Wales - safeguarding children and vulnerable adults policies
- NHS Scotland - protecting Scotland's children and young people
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UK law (Scotland): Protection of Children (Scotland) Act 2003, Age of Legal Capacity (Scotland) Act 1991
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- NHS NI - co-operating to safeguard children in Northern Ireland
- Evidence from the Child Death Overview process - this is available locally and is provided by the LSCBs in England and a nation review is also published annually alongside various serious case reviews. There is a triennial review of serious incidents.
Key issues for Child Death Overview Process (CDOP) as a result of proposed changes to Working Together published October 2018 (NB: these changes apply to England only)
Overarching changes:
- Political responsibility for child death review will move from DfE to DH
- Local responsibility for review rests with the local authority and CCGs
- A National child death mortality database to be established to collate national data has begun work. Expected implementation 2020
- Revised guidelines (WT 2018) published autumn 2018 set out the responsibility of child death review partners
- Revised forms for information gathering and analysis issued in autumn 2018. These are now called:
- Notification form (previously known as form A)
- Reporting form (previously known as Form B)
- Analysis form (previously known as Form c). From 2020 this information will be shared with the national child mortality database. Currently data is sent to NHS digital.
- Revised guide for families also due to be published.
Joint agency response:
This is a co-ordinated multi-agency response which will be triggered if the death:
- Is or could be due to external causes
- Is sudden and no apparent cause (including SUDI/C)
- Occurs in custody, or where child detained under Mental Health Act
- Initial circumstances raise suspicions that death may not have been natural
- Still birth where no healthcare professional in attendance
Aim of child death review is to:
Identify cause of death
- Provide support to families
- Identify modifiable/contributory factors
- Ensure statutory obligations are met
- Learn lessons. Promote health and wellbeing of other children.
Changes to process of child death review
All deaths in children should follow a similar path to include:
- Immediate decision making and notifications to include decision as to whether needs joint agency response (involve Rapid response team to aid information gathering for unexpected death)
- Investigation and information gathering
Child death review meeting needs to be flexible and proportionate but be held for all child deaths not just unexpected deaths
- CDOP (Child Death Overview Process)
- National child mortality database
- Support for families - Families should have an identified key worker to act as named point of contact throughout the process of the child death review.
NICE Guidelines
Guideline (NG55) 2016 - Harmful sexual behaviour among children and young people
This guideline covers children and young people who display harmful sexual behaviour, including those on remand or serving community or custodial sentences. It aims to ensure these problems don’t escalate and possibly lead to them being charged with a sexual offence. It also aims to ensure no one is unnecessarily referred to specialist services.
Guideline (NG76) 2017 - Child abuse and neglect
This guideline covers recognising and responding to abuse and neglect in children and young people aged under 18. It covers physical, sexual and emotional abuse, and neglect. The guideline aims to help anyone whose work brings them into contact with children and young people to spot signs of abuse and neglect and to know how to respond. It also supports practitioners who carry out assessments and provide early help and interventions to children, young people, parents and carers.
Clinical features of abuse and neglect (including physical injury) are covered in NICE’s guideline on child maltreatment. Recommendations relevant to both health and social care practitioners appear in both guidelines.
Patterns of bruising in preschool children—a longitudinal study
Kemp AM, et al. Arch Dis Child 2015;0:1–6. doi:10.1136/archdischild-2014-307120
What this study says:
Bruising affects a small proportion of babies who cannot roll over.
- Rare sites for bruising: ears, neck, genitalia, hands, in any child and buttocks and front trunk in early and premobile children.
- Nine per cent of children have twice as many bruises as would be expected for their developmental stage.
Sudden Unexpected Deaths in Infancy (SUDI)
Following three high profile criminal cases involving prosecution of mothers for the death of their child(ren) an intercollegiate (RCPath/RCPCH) working party produced a protocol for handling sudden unexpected death in infants (SUDI) in 2003. This has recently been revised (November 2016). It has been extended to include all deaths in infancy and childhood.
(Please note that this protocol is for England and does not describe the process for Scotland and Wales).